Intranasal insulin to improve developmental delay in children with 22q13 deletion syndrome: an exploratory clinical trial.
BACKGROUND
The 22q13 deletion syndrome (Phelan-McDermid syndrome) is characterised by a global developmental delay, absent or delayed speech, generalised hypotonia, autistic behaviour and characteristic phenotypic features. Intranasal insulin has been shown to improve declarative memory in healthy adult subjects and in patients with Alzheimer disease.


OBJECTIVE
To assess if intranasal insulin is also able to improve the developmental delay in children with 22q13 deletion syndrome.


METHODS
We performed exploratory clinical trials in six children with 22q13 deletion syndrome who received intranasal insulin over a period of 1 year. Short-term (during the first 6 weeks) and long-term effects (after 12 months of treatment) on motor skills, cognitive functions, or autonomous functions, speech and communication, emotional state, social behaviour, behavioural disorders, independence in daily living and education were assessed.


RESULTS
The children showed marked short-term improvements in gross and fine motor activities, cognitive functions and educational level. Positive long-term effects were found for fine and gross motor activities, nonverbal communication, cognitive functions and autonomy. Possible side effects were found in one patient who displayed changes in balance, extreme sensitivity to touch and general loss of interest. One patient complained of intermittent nose bleeding.


CONCLUSIONS
We conclude that long-term administration of intranasal insulin may benefit motor development, cognitive functions and spontaneous activity in children with 22q13 deletion syndrome.
Schmidt
H
H
Dr von Hauner Children's Hospital, University of Munich, Lindwurmstr. 4, 80337 Munich, Germany. heinrich.schmidt@med.uni-muenchen.de
Kern
W
W
Giese
R
R
Hallschmid
M
M
Enders
A
A
D000281:Administration, Intranasal; D002648:Child; D002675:Child, Preschool; D002872:Chromosome Deletion; D025063:Chromosome Disorders / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D002892:Chromosomes, Human, Pair 22 / Q000235:genetics*; D003071:Cognition / Q000187:drug effects; D002658:Developmental Disabilities / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007223:Infant; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D009048:Motor Skills / Q000187:drug effects; D013577:Syndrome; D013997:Time Factors; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D007328:Insulin